Set in Switzerland in the era of WWI and up to the mid-1920s, we first meet Seraphine where she lives in the Alps. Her life is hard. She’s the illegitimate child of an unwed mother who has found a husband and given birth to two other children. The two children (sons) suffer from cretinism (congenital hypothyroidism) and the daughter (as well as the mother) has a goiter condition.

The daughter has the burden of caring for the family with her work tending the sheep as well caring for her brothers. The father is off patrolling the borders and the mother is clearly depressed and doesn’t do much other than sit at the house. The only break Seraphine gets is when she’s at school.

We’re then introduced to Bastian, a young man who was in medical school but conscripted into the army during the war. Eventually, he is mustered out and returns to school in Zurich. We meet his friends and learn about his life.

The chapters alternate with the two main characters and also include newspaper articles of the era detailing the Russian revolution and the Swiss workers’ strikes, as well as letters between a number of people that help move the story along.

Eventually, Bastian comes to the Alps to assist a doctor who is working on a cure for cretinism and goiters and the two main characters meet.

The book is called Salt of the Earth for a reason as this doctor, among others, believes these conditions are caused by a lack of iodine in the diet. It’s especially important to not have an iodine deficiency in the preconception stage. The doctors’ work focuses on helping the people of the Alps and concentrates as well on the pregnant population to try to stop these conditions from manifesting in the infants and children.

Intrigued by the story and the iodine component, I took a deep dive into the history of this disease and who started the research into a cure. The author used the real history in the story, even naming the doctor, H. Eggenberger, as a peripheral character, as well as using Otto Bayard as a mentor to the male protagonist.

She also used Anna Heer, a female doctor, who founded the first professional nursing school in Switzerland. The female protagonist also did some work with a real person, Lotte Volger, who specialized in moulaguese. I had never heard of moulages so did a look around online about them as well. They were wax models of how certain conditions manifested themselves on patients. Lot of great innovation happening in Zurich medically in that era and I love how it was woven into the tale without being boring.

I learned a lot reading this story. I love novels that use real events from the past as a jumping off point for the book. When such whets my appetite for more information, that’s even better. The author even worked in a famous murder that occurred in Santis, Switzerland in order to get the male protagonist out of a sticky situation he found himself in. It was quite a clever use of a historical event in the time period.  

I’m also curious about the author and why this thyroid condition intrigued her enough to write this book. I guess I’ll never get the answer to that question. Haha.

Historically set with a lot of references to everything that was happening in this era, this is an enjoyable story with characters who speak to the reader with their kindness and concern, not only for their loved ones, but for humanity at large. I liked the characters and the setting as well as how the author wove all the elements together.

A lovely read and beautiful story that I very much enjoyed.